about nasal polyp and its treatment (hom.medicine)

1. By d.g

2. There are two types of nasal polyp
 Antrochoanal
 Ethmoidal

4. Antrochoanal type
 It arises from the maxillary antrum and grows backwards in to
nose towards the choana and nasal cavity riches the nasopharynx .

5. Ethmoidal
 They are multiple bilateral and arises from numerous ethmoidal
sinuses.
 It is very commonly found

6. Etiology
 ANTROCHOANAL POLYP-
 Exact cause is not known.
 AGE: usually it occurs in children and young adults.
 NUMBER: usually it is single.
 INFECTION and ALLERGY may result in ANTROCHOANAl
POLYP.

7. ETHMOIDAL POLYP
 AGE; ethmoidal polyps occurs at any age
 SEX: both sexes are equally affected
 PREDISPOSING FACTOTRS:
 Allergy
 Vasomotor
 Infection
 Mixed infection

8. Polysaccharide changes
Bernouillis phenomenon: when air passes
through a narrow area in the nose negativre
pressure develops in the viscinity in the
paranasal sinuses leading to increased formation
of tissue fluids this may encourage polyp
formation.

9. Asthma can be associated with ethmoidal polyp.
Aspirin sensitivity

10. Pathology
Antrochoanal polyp
Macroscopic :antral part : arise from
maxillary antrum.
Mucosa:oedamatous
Nasal part: arise from hiatus semilunaris
in nose and reaches the choana

11.  Pharyngeal part :enters the naso pharynx through choana.
 ETHMOIDAL POLYP:
 Arised from mucosa ethmoidal sinuses and hang down in the nasal
cavity .

12. antrochoanal polyp showing
choanal (c)nasal (n) antral (a) parts
A
C
N

13. Microscopic
 Mucous membrane: metaplastiv changes.
 Polyp: ulcerated or protruded
 Submucoasal tissue:oedamtoius.
 Cellular infiltration occurs
 Polyp is avascular and pain less
 Blood vessels and nerves supply scanty

14. DIAGRAM OF NASAL POLYPI

15. Clinical features
 Blocking of nose
 Sneezing
 Discharger clear
 Expansion of nose
 Anosmia
 Snoring and mouth breathing
 headache

16.  Epiphora
 Postnasal discharge
 Speech:hyponasal

18. Signs
 External nose: Frog like appearance “BROAD NOSE”
 Anterior rhinos copy:
 antrochonal :rarely visible
 Ethmoidal:multiple like n bunch of grapes
 Posterior rhinoscopty
 Antrochoanal :large visible like pear shaped
 Ethmoidal :fairly visible and grow slowly

20. Investigation
 Nasal secretion : culture and sensitivity test
 Radiography test of nose and sinuses.
 Ct scan of nose and par nasal sinuses.
 Biopsy of polyp

21. DIFFERENTIAL DIAGNOSIS
 Hypertrophic turbinate's
 Rhinospordiosis
 Malignancy
 Angioma
 Adenods
 Nasopharangeal angiofibroma
 Nasophrangeal malignancy
 Glioma
 menegiocle

22. Treatment
 antrochoanal polyp: conservative
 nasal decongestant
 anrttibiotics
 surgical:polypectomy
 sinoscopy
 cold weell luc-operation

23. ETHOMOIDAL POLYP
 conservative:antihistamine
 steroids
 antibiotics xecongesatant
 surgical:polypectomy
 ethmoidectomy
 sinoscopy

24. HOMOEOPATHIC TREATMENT
 calc.carb
 kreosotum
 phosphorus
 hamamelis

25. DNS
 deviated nasal septum:
 defination:deviation of the septum occurs very frquentlybut it
requires treatment only if it produces symptoms

26. ETIOLOGY
 AGE:puberty
 upto 20 yrs
 sex :both sexes
 hereditoyry
 developmental cause
 high arched palate
 congenital

27. trauma
secondary :tumor
mass
polyp

28. PATHOLOGY
 deviation
 spurs
 thickening
 dislocation
 c-shaped or s shaped deviation
 hypertrophy of turbinates

30. SYMPTOMS
 asypmtomatic
 blocking of nose
 vacuum headache
 neuralgic headche
 recurrent cold
 epistaxis
 anosmia
 deformity

31. INVESTIGATION
 examination of nose
 anterior rhinoscopy
 posterior rhinoscopy
 radiography of face or nose

32. COMPLICATION
 recurrent sinusitis
 middle ear infection
 mouth breathing
 asthma
 atrophic rhinitis

33. DIFFERENTIAL DIAGNOSIS
hypertrophic turbinates
polyp
septal haematoma

34. HAEMATOMA

35. TREATMENT
SMR(submucosal resection of nasal septum)
septoplasty

36. HOMOEOPATHIC TREATMENT
 ars.alb
 aconite
 thuja